The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act (ARRA), devoted $19.2 billion to increase the use of Electronic Medical Records (EMRs) and other forms of information technology (IT) by healthcare providers. Underlying this substantial public subsidy is a belief that creating an electronic rather than a paper interface between patient information and healthcare providers can improve healthcare quality and also save money. Although recent studies have provided supportive evidence of a positive role for health IT in the hospital setting, less is known about the impact of IT use on quality in ambulatory care. This is despite the fact that most health services are delivered in such settings and the potential gains from health IT may be larger there. The proposed research will address that gap in two stages. First, it will develop a longitudinal national database on local area healt IT use that could potentially affect ambulatory care. The database will include health IT applications in place at ambulatory facilities as well as local hospitals and hospital systems. It will measure different types of health IT as well as the technological resources in place for health information exchange among ambulatory providers, between ambulatory providers and hospitals, and between providers and patients. The second stage of the research will estimate the impacts of various measures of local health IT on the quality of ambulatory care and on racial and ethnic disparities in health care quality. Estimation will be conducted on a merged panel database on local areas over time using multivariate regression models with local area controls and differences-in-differences models that control for unmeasured factors that are correlated with both quality and IT adoption. PUBLIC HEALTH RELEVANCE: U.S. government investments in health information technology (IT) hold substantial promise for improving health care quality among U.S. residents and improving efficiency in the U.S. health care system. Some research has explored the effects of health IT in hospital settings; this research project quantifies the effect of health ITon the quality of health care in ambulatory care settings.